OBJECTIVES: To evaluate the role of lymphography in comparison with other diagnostic modalities such as ultrasound and computed tomography in the staging and follow-up of patients with appropriate malignancies. METHODS EMPLOYED: Bipedal lymphography is routinely performed on patients with a variety of malignancies, including malignant lymphomas, testicular tumors, carcinoma of the prostate, carcinoma of the ovary, and mycosis fungoides. Follow-up radiographs are performed at periodic intervals and an evaluation of the opacified retroperotoneal lymph nodes is made to assess disease progression. The results are compared with other modalities to assess their relative value in following patients with underlying malignancy. MAJOR FINDINGS: Percutaneous lymph node aspiration has enabled radiologists to clarify equivocal lymphograms and document the presence of tumor. This has been particularly helpful after therapy has altered the appearance of the opacified retroperitoneal lymph nodes. Lymphography has been useful as one of several modalities in following patients with carcinoma of the prostate. It is limited in part by the relatively poor filling of retroperitoneal lympho nodes in older patients. Bipedal lymphography has thus far been quite useful in patients with testicular carcinoma, ovarian carcinoma, and malignant lymphomas. The better detail provided by lymphography is helpful in small sites of metastatic disease. Extranodal disease is easier detected by computer tomography. Bulky disease can usually be readily identified by either method.